Carbon Monoxide (CO) exposure kills and injures thousands of children and families each year. CO poisoning is common and accounts for 40,000 to 50,000 emergency department visits annually. Children and adolescents younger than 15 years old make up 26% of non-fatal unintentional non-fire-related carbon monoxide exposures. Known effective countermeasures to detect CO and reduce CO poisoning exist, yet are not routinely utilized. Although there is increasing concern about the need to increase CO detector use, little is known about how best to do so, especially for low income families. This application begins to address this gap, by applying a theory of stage-based behavior change-the Precaution Adoption Process Model (PAPM)-to a brief intervention feasible for a busy emergency department setting. The long-term goal of this research is to reduce the number of injuries and deaths from CO poisoning. The objective of this research is to determine whether a brief intervention, Project Carbon Monoxide Detector Education (Project CODE), will increase CO detector use. A randomized trial will be conducted involving 300 families with young, adolescent, and teenage children. Parents will be randomly assigned to receive Project CODE (an educational tool and receipt of a CO detector) or usual care (a flyer on CO poisoning); both of which will be delivered in the Pediatric Emergency Department (PED) waiting room. The primary outcome measures will be the use of a CO detector and PAPM stage assessed at a home visit two weeks following the PED visit and follow-up home visit one year later. We hypothesize that parents receiving Project CODE will have working CO detectors and will be at a further along in the PAPM than parents in the control group at a two-week and follow-up home observations. By examining the extent to which the intervention increases CO detector use, these findings will also demonstrate how innovative health communications (brief interventions delivered in the PED) can reduce the risk of injuries among vulnerable children. This application builds on and extends the investigators' previous work on behavioral theory, injury prevention interventions delivered in the PED, and development and evaluation of interactive educational tools for safety practices. The specific aims of this project are as follows: Aim 1-Determine whether a brief intervention will increase CO detector use and PAPM stage among parents whose children are being seen in a PED compared to parents of children receiving routine care a CO flyer; and Aim 2-Determine whether and to what extent socioeconomic status moderates the effect of the intervention. Findings from the proposed research will have both theoretical and practical applications for improving injury prevention services in PEDs. This single-site efficacy trial is the first step in determining whether a brief intervention in the PED will successfully increase CO detector use. This study, if successful, should lead to additional PED brief interventions for other safety topics. PUBLIC HEALTH RELEVANCE: Carbon Monoxide (CO) exposure kills and injures thousands of children and families each year. Known effective countermeasures exist, yet are not routinely utilized. Although there is increasing concern about the need to increase CO detector use, little is known about how best to do so, especially for low income families. The relevance of this research to public health is reducing the risk of injuries among children by increasing parent safety practices. [unreadable] [unreadable] [unreadable]